CQC assurance on MDT meetings

Accept

CQC has now added more detailed and specific prompts on multidisciplinary teamworking to the inspection framework for diagnostic imaging services in NHS and independent acute hospitals, including reference to NHSEI’s guidance on streamlining multidisciplinary team meetings for cancer alliances.

When assessing providers in the NHS and the independent sector, CQC will continue to seek assurance that patients are not at risk of harm due to non-compliance with this guidance.

The government accepts this recommendation in full and agrees it is vital that multidisciplinary team (MDT) arrangements are effective and fit for purpose, and that they meet the most up-to-date guidance regarding their use.

Under the Care Quality Commission’s (CQC) assessment framework, the CQC assesses providers for multidisciplinary teams (MDT) working under the quality statement, How staff, teams and services work together. Where this quality statement is assessed for individual services, an assessment report with the CQC’s findings is published on the CQC website.

The CQC is currently consulting on sector-specific assessment frameworks following reviews into their operational effectiveness by Dr Penny Dash, Sir Professor Mike Richards, and the Care Provider Alliance. MDT working would be assessed in future under the hospitals framework, both secondary and specialist care, via the Safe systems, pathways and transitions key line of enquiry and via the Delivering evidence-based care and treatment key line of enquiry.

The NHS Constitution sets out the six core NHS values. These include commitment to quality of care and working together for patients. These values are set at the highest level by the Department of Health and Social Care through the NHS Constitution and the Government’s Mandate to NHS England.

Effective communication and team working is a vital component in providing quality care in health. Good communication skills within and between teams benefits patients, but also those working as part of the team, helping reduce risks and providing support for staff. There are several tools which have been developed to assist this:

• The NHS Long Term workforce plan, which contains a specific focus on optimising multi-disciplinary teams (MDTs).

• Guidance on information sharing in MDTs, developed by NHS England, the Information Commissioners Office and the National Data Guardian.

• Professional regulators, such as:

• GMC guidance on Decision Making and Consent, which provides advice on wider team involvement but also the delegation of decision making.
• The GMC provide guidance on working with colleagues, outlining how respect and good communication is essential for good and safe patient care.

• Working differently together, a toolkit developed by Health Education England (now part of NHS England), provides a step-by-step guide to help progress a ‘one workforce’ approach across health and care organisations and ICSs. ‘One workforce’ is intended to be indicative of a workforce drawn from a range of health and social care disciplines, working seamlessly as a productive, multifunctional team across clinical pathways.

• Specific resources for communications in cancer

The CQC considers the effectiveness of MDT working when it assesses services. CQC have now implemented and started assessing against the new Single Assessment Framework (SAF), where MDT working is assessed under the Effective Quality Statement for how staff, teams and services work together. CQC has published high-level guidance and will reflect the specifics of the cancer MDT prompts in service specific guidance.

In July 2024, CQC appointed Professor Sir Mike Richards to review the Single Assessment Framework. The aim of this short-term review is to support CQC in addressing the concerns relating to the SAF and its implementation identified in the interim report by Penny Dash.

In March 2024, NHS England published guidance for local health and social care systems on implementing a timed breast cancer diagnostic pathway. This guidance complements existing resources such as National Institute for Health and Care Excellence (NICE) guidelines. This pathway was developed by a multidisciplinary consensus group with clinical leaders from local and specialist services across England, expert advice from cancer alliances, and people with lived experience.

Action 3.1

This recommendation has been implemented. CQC has incorporated specific prompts on MDT working into its existing inspection framework for all registered IS providers, including detailed questions on practical arrangements for MDTs with reference to appropriate national guidance. CQC’s inspection frameworks for IS and NHS providers continue to include detailed questions on practical arrangements for MDTs and reference appropriate national guidance. CQC’s new regulatory model which is being rolled out in 2023 will include continued effective monitoring of MDT use.

Action 3.1:

Accepted by the government.

The Care Quality Commission has now added more detailed and specific prompts on multidisciplinary teamworking to the inspection framework for diagnostic imaging services in NHS and independent acute hospitals.